Nutrition and Age-Related Macular Degeneration

In the United States age-related macular degeneration (AMD) is the leading cause of blindness (visual acuity < 20/200) in elderly patients[1].

Non-modifiable risk factors for disease include genetic susceptibility, race, eye color, female gender, and age. Modifiable risk factors include cigarette smoking, hypercholesterolemia, obesity, chronic exposure to ultraviolet light, and nutritional status[2]. Prevention of disease has been focused on smoking cessation, maintenance of a healthy diet, and vitamin and mineral supplementation.

Retinal Venous Occlusion

Retinal venous occlusion is among the foremost causes of sudden painless loss of vision and the second most prevalent retinal vascular disease after diabetic retinopathy. The rubric retinal venous obstructive disease includes two primary manifestations: branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). Although BRVO and CRVO differ in terms of pathophysiology and clinical course, the shared mechanisms for decreased vision include retinal edema, retinal hemorrhage, retinal ischemia, and vitreous hemorrhage. Eighty percent of retinal vein occlusions are BRVO’s[1]. Associations with BRVO include hypertension, cardiovascular disease, increased body mass index by age 20, and glaucoma[2]. The pathophysiology of BRVO typically originates in the retinal vascular anatomy wherein retinal arteries and veins share a common adventitial sheath. As arteriosclerotic changes develop in the arteries, secondary venous compression results in turbulent blood flow leading to endothelial damage and thrombus formation.

Neovascular Glaucoma

by Gary Belen, M.D.

About neovascular glaucoma

Neovascular glaucoma (NVG) is a potentially devastating result of serious underlying ocular and/or systemic diseases. Most cases of NVG are preceded by ischemic disease of the retina, and the subsequent release of diffusible angiogenic factors which promote new blood vessel growth. It is imperative to make the diagnosis early, and then initiate immediate and aggressive treatment. A delayed diagnosis or poor management can result in complete loss of vision, and possibly even loss of the globe itself.

Diabetic Retinopathy

Diabetic retinopathy (DR) remains the leading cause of vision loss among American adults. The prevalence of diabetes continues to rise and is currently estimated by the CDC at 9.6% of adults over 20 years of age. Fortunately, most vision loss from DR is preventable with a combination of diabetic control and the treatment of ocular manifestations.

Diabetic control has proven to be the cornerstone of preventing retinopathy and vision loss. The risk of DR and vision loss is directly related to the duration of diabetes and the level of glycemic control. Other modifiable risk factors include hypertension and hyperlipidemia. In cases of visual impairment specifically due to macular edema, the use of oral glitazones has also been implicated as a contributing factor.